What are the main differences between an earache and an ear infection. How can you identify the symptoms of each condition. What are the most effective treatment options for ear pain and infections. When should you seek medical attention for ear-related issues. How can ear problems be prevented in both children and adults.

Understanding Earaches: Causes and Symptoms

An earache is a general term for pain in one or both ears. This discomfort can manifest as sharp, dull, or burning sensations and may be temporary or persistent. Earaches can stem from various sources, not all of which are directly related to ear infections.

Common causes of earaches include:

• Otitis media (middle ear infection)
• Swimmer’s ear (outer ear infection)
• Malignant otitis externa (severe outer ear infection)
• Temporomandibular joint (TMJ) disorders
• Dental problems
• Sinus infections
• Throat infections
• Pressure changes (e.g., during air travel)
• Foreign objects in the ear
• Earwax buildup

Can earaches occur without an infection? Yes, earaches can result from non-infectious causes such as TMJ disorders, dental issues, or pressure changes. It’s important to identify the underlying cause to determine the appropriate treatment.

Ear Infections Explained: Types and Characteristics

Ear infections are a specific cause of ear pain and can be classified into three main types:

1. Otitis externa (outer ear infection)
2. Otitis media (middle ear infection)
3. Otitis interna (inner ear infection)

Otitis media is particularly common in children due to their shorter and more horizontal Eustachian tubes, which can become easily blocked. This blockage can lead to fluid buildup and create an environment conducive to bacterial growth.

Are ear infections always bacterial? No, ear infections can be caused by both bacteria and viruses. Viral infections are more common and often resolve on their own, while bacterial infections may require antibiotic treatment.

Symptoms of Ear Infections

Ear infections often present with the following symptoms:

• Ear pain (otalgia)
• Fever
• Irritability (especially in children)
• Difficulty sleeping
• Fluid drainage from the ear
• Temporary hearing loss
• Balance issues

Is hearing loss a common symptom of ear infections? Yes, temporary hearing loss can occur during or immediately after an ear infection. In most cases, this resolves once the infection clears. However, recurrent infections may increase the risk of long-term hearing problems.

Diagnosing Ear Problems: When to Seek Medical Attention

While many earaches and mild infections can be managed at home, certain symptoms warrant professional medical evaluation:

• Severe pain or pain lasting more than 48 hours
• High fever (above 102.2°F or 39°C)
• Bloody or pus-like discharge from the ear
• Swelling around the ear
• Facial weakness or paralysis
• Persistent hearing loss
• Dizziness or balance problems

How do healthcare providers diagnose ear problems? Doctors typically perform a physical examination, looking at the ear canal and eardrum using an otoscope. They may also conduct hearing tests or use tympanometry to assess eardrum function.

Treatment Options for Earaches and Ear Infections

The appropriate treatment for ear pain depends on its underlying cause. Here are some common approaches:

Home Remedies

• Applying a cold or warm compress to the affected ear
• Over-the-counter pain relievers (e.g., acetaminophen, ibuprofen)
• Chewing gum to relieve pressure
• Resting in an upright position
• Using over-the-counter ear drops (if the eardrum is intact)

Medical Treatments

• Antibiotics for bacterial infections
• Antiviral medications for certain viral infections
• Ear tubes for recurrent infections or persistent fluid buildup
• Myringotomy (surgical incision in the eardrum) to drain fluid

Do all ear infections require antibiotics? No, many ear infections, particularly those caused by viruses, resolve on their own without antibiotics. Healthcare providers often recommend a “wait-and-see” approach for mild cases, prescribing antibiotics only if symptoms persist or worsen.

Preventing Ear Problems: Strategies for Adults and Children

While not all ear issues are preventable, certain measures can reduce the risk of earaches and infections:

• Practicing good hygiene, including regular handwashing
• Avoiding exposure to secondhand smoke
• Managing allergies effectively
• Breastfeeding infants (which can boost immunity)
• Avoiding insertion of foreign objects into the ear canal
• Drying ears thoroughly after swimming or bathing
• Using earplugs during water activities
• Maintaining up-to-date vaccinations

Can diet affect ear health? Yes, a balanced diet rich in vitamins and minerals can support overall immune function, potentially reducing the risk of infections. Some studies suggest that probiotics may also help prevent ear infections in children, though more research is needed.

Special Considerations for Children and Ear Health

Children, especially those under five years old, are more prone to ear infections due to their anatomy and developing immune systems. Parents and caregivers should be aware of the following:

• Bottle-feeding position: Feeding infants in a more upright position can help prevent milk from flowing into the Eustachian tubes.
• Pacifier use: Limiting pacifier use, particularly after 6 months of age, may reduce the risk of ear infections.
• Secondhand smoke: Exposure to smoke significantly increases a child’s risk of ear infections.
• Daycare attendance: Children in group childcare settings are more likely to be exposed to infectious agents.

How can parents differentiate between normal fussiness and ear pain in infants? Look for signs such as tugging or pulling at the ears, increased irritability, difficulty sleeping, and fever. If these symptoms persist or worsen, consult a healthcare provider.

Complications and Long-term Effects of Ear Problems

While most earaches and infections resolve without lasting effects, recurrent or severe cases can lead to complications:

• Chronic otitis media
• Mastoiditis (infection of the mastoid bone)
• Cholesteatoma (abnormal skin growth in the middle ear)
• Tympanic membrane perforation
• Hearing loss
• Speech and language delays in children

Can ear infections cause permanent hearing loss? While rare, repeated or severe ear infections can potentially lead to permanent hearing damage. This risk underscores the importance of proper management and prevention of recurrent infections.

Emerging Research and Future Directions in Ear Health

Ongoing research in otolaryngology continues to advance our understanding and treatment of ear-related issues:

• Development of new antimicrobial treatments
• Exploration of immunotherapies to prevent recurrent infections
• Advancements in diagnostic tools for more accurate and timely detection
• Investigation of genetic factors influencing susceptibility to ear infections
• Research into the long-term effects of childhood ear infections on cognitive development

What promising treatments are on the horizon for ear infections? Researchers are exploring new antibiotics that can overcome antibiotic resistance, as well as vaccines targeting common pathogens responsible for ear infections. Additionally, novel drug delivery methods, such as antibiotic-eluting ear tubes, show potential for improving treatment outcomes.

In conclusion, understanding the differences between earaches and ear infections, recognizing their symptoms, and knowing when to seek medical attention are crucial for maintaining ear health. By implementing preventive measures and staying informed about treatment options, individuals can effectively manage ear-related issues and minimize their impact on overall well-being. As research continues to advance, we can look forward to even more effective strategies for diagnosing, treating, and preventing ear problems in the future.

Earache: MedlinePlus Medical Encyclopedia

An earache is a sharp, dull, or burning pain in one or both ears. The pain may last a short time or be ongoing. Related conditions include:

• Otitis media
• Swimmer’s ear
• Malignant otitis externa

The symptoms of an ear infection may include:

• Ear pain
• Fever
• Fussiness
• Increased crying
• Irritability

Many children will have minor hearing loss during or right after an ear infection. Most of the time, the problem goes away. Lasting hearing loss is rare, but the risk increases with the number of infections.

The eustachian tube runs from the middle part of each ear to the back of the throat. This tube drains fluid that is made in the middle ear. If the eustachian tube becomes blocked, fluid can build up. This may lead to pressure behind the eardrum or an ear infection.

Ear pain in adults is less likely to be from an ear infection. Pain that you feel in the ear may be coming from another place, such as your teeth, the joint in your jaw (temporomandibular joint), or your throat. This is called “referred” pain.

Causes of ear pain may include:

• Arthritis of the jaw
• Short-term (acute) ear infection
• Long-term (chronic) ear infection
• Ear injury from pressure changes (from high altitudes and other causes)
• Object stuck in the ear or buildup of ear wax
• Hole in the eardrum
• Sinus infection
• Sore throat
• Temporomandibular joint syndrome (TMJ)
• Tooth infection

Ear pain in a child or infant may be due to infection. Other causes may include:

• Ear canal irritation from cotton-tipped swabs
• Soap or shampoo staying in the ear

The following steps may help an earache:

• Place a cold pack or cold wet washcloth on the outer ear for 20 minutes to reduce pain.
• Chewing may help relieve the pain and pressure of an ear infection. (Gum can be a choking hazard for young children.)
• Resting in an upright position instead of lying down can reduce pressure in the middle ear.
• Over-the-counter ear drops can be used to relieve pain, as long as the eardrum has not ruptured.
• Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can provide relief for children and adults with an earache. (DO NOT give aspirin to children.)

For ear pain caused by a change of altitude, such as on an airplane:

• Swallow or chew gum as the plane descends.
• Allow infants to suck on a bottle or breastfeed.

The following steps can help prevent earaches:

• Avoid smoking near children. Secondhand smoke is a major cause of ear infections in children.
• Prevent outer ear infections by not putting objects in the ear.
• Dry the ears well after bathing or swimming.
• Take steps to control allergies. Try to avoid allergy triggers.
• Try a steroid nasal spray to help reduce ear infections. (However, over-the-counter antihistamines and decongestants do not prevent ear infections.)

Contact your health care provider if:

• Your child has a high fever, severe pain, or seems sicker than is usual for an ear infection.
• Your child has new symptoms such as dizziness, headache, swelling around the ear, or weakness in the face muscles.
• Severe pain suddenly stops (this may be a sign of a ruptured eardrum).
• Symptoms (pain, fever, or irritability) get worse or do not improve within 24 to 48 hours.

The provider will do a physical exam and look at the ear, nose, and throat areas.

Pain, tenderness, or redness of the mastoid bone behind the ear on the skull is often a sign of a serious infection.

Otalgia; Pain – ear; Ear pain

• Ear tube surgery – what to ask your doctor

• Ear anatomy
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Earwood JS, Rogers TS, Rathjen NA. Ear pain: diagnosing common and uncommon causes. Am Fam Physician. 2018;97(1):20-27. PMID: 29365233 pubmed.ncbi.nlm.nih.gov/29365233/.

Haddad J, Dodhia SN. General considerations in evaluation of the ear. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 654.

Pelton SI. Otitis externa, otitis media, and mastoiditis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 61.

Player B. Earache. In: Kliegman RM, Toth H, Bordini BJ, Basel D, eds. Nelson Pediatric Symptom-Based Diagnosis. 2nd ed. Philadelphia, PA: Elsevier; 2023:chap 5.

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Ear Ache vs. Ear Infection: What’s the Difference?

Ear pain can range from a minor nuisance to a major source of agony. Ear pain is a common problem, especially in children, and can have a number of causes – some of which have nothing to do with the ear.

But how to know whether it’s an ear ache or an ear infection? And when is it serious enough to seek medical help? We talked with UH family medicine physician Meredith Hale, DO, to find out.

Ear Infections

Ear infections are the most common cause of ear pain. It’s especially common in children and is the most common reason parents bring their child to a doctor. In fact, five out of six children will have at least one ear infection by their third birthday.

An ear infection happens when fluid in the interior space behind the eardrum becomes infected, usually with bacteria. The tube leading into the body becomes blocked, and fluid builds up behind the eardrum. The increased pressure pushes the eardrum outward, causing pain and fever.

An ear infection often occurs after a sore throat, cold or other upper respiratory infection, Dr. Hale says. Symptoms include hearing loss, fever and feeling unwell.

Most ear infections happen to children before they’ve learned how to talk. Here are a few things parents should look for if they suspect their young child has an ear infection:

• Tugging or pulling at the ear
• Fussiness and crying
• Trouble sleeping
• Fluid draining from the ear
• Clumsiness or balance problems

Ear Ache

Ear aches are not always caused by an ear infection. Other conditions also can cause ear ache or ear pain, especially in adults.

Ear ache is often described as a feeling of pressure in the ear.

“It can begin suddenly or gradually, and it can be quite severe,” Dr. Hale says.

Aside from infection of the inner ear, other causes of ear pain include:

• Injury
• Swimmer’s ear – inflammation and infection in the channel that leads from the eardrum to the outside.
• Cellulitis — infection of the external ear and ear lobe
• Pain caused by irritation of the nerves in the ear
• Pain from a sore throat or a problem with the jaw joints
• Referred pain from infections or inflammation elsewhere in the body such as a toothache
• Allergic reactions from soap, shampoo, earrings or other allergens
• Water trapped in the ear
• Changes in altitude

Many people wonder if ear wax buildup causes ear pain. Normally, your ear canal does not need to be cleaned. But sometimes ear wax does build up, become impacted and cause symptoms, usually a sensation of fullness or muffled sound as if you are wearing ear plugs.

“When too much wax blocks the ear, you may feel pressure, but this usually doesn’t cause pain,” Dr. Hale says.

When To See a Doctor

Ear infections don’t always need to be treated with antibiotics. “Sometimes, we observe and initiate antibiotic therapy if signs and symptoms worsen or fail to improve after 48 to 72 hours,” Dr. Hale says.

If your child has repeated ear infections or trouble hearing, your doctor may suggest meeting with an ear, nose and throat specialist to discuss placing small tubes in your child’s ear to help maintain a healthy environment.

If you experience intense pain, a high fever or a hearing loss, it’s important to seek medical attention immediately, Dr. Hale says.

Related Links

At University Hospitals, we believe having a primary care provider is essential to your health and well-being. Our primary care physicians and nurses provide comprehensive, compassionate and continuous primary care for patients of all ages. We are committed to building a healthy relationship with you and your family to detect and minimize long-term health issues, or just help you get over that illness that’s going around. Need a primary care provider? Find one here.

causes, symptoms, diagnosis and treatment

• Mastoiditis is an inflammation of the mucous membrane of the mastoid process of the temporal bone. It is located behind the auricle, has a cellular structure and is normally filled with air. The disease is most often secondary, with the exception of injuries.

  Causes

  The most common route of infection is from the middle ear during suppurative otitis media. Pathogens can be different:
  – streptococcus;
  – staphylococcus aureus;
  – moraxella;
  – hemophilic or Pseudomonas aeruginosa;
  – mycobacteria.

  Rare is the spread of infection through the bloodstream in the presence of a primary focus of tuberculosis, syphilis or sepsis.

  Primary infection develops in case of various injuries (traumatic brain injury, gunshot wound, fall, blow, etc.). A decrease in local and / or general immunity increases the likelihood of developing mastoiditis. Risk factors include:
  – rheumatoid arthritis;
  – bronchitis;
  – diabetes mellitus;
  – hepatitis;
  – pyelonephritis.

  Violation of the anatomical integrity of the middle ear may be a trigger factor for the development of the disease.

  Symptoms

  The first signs of illness appear approximately seven days after the onset of the primary illness or injury. These symptoms are not specific:

  • Deterioration of general condition.
  • Headache.
  • Febrile body temperature.
  • Sleep problems.

  After some time, patients begin to complain of tinnitus, a feeling of blood pulsation, pain in the behind the ear area, spreading to the face (eyes, upper jaw). Objectively, the skin over the mastoid process is edematous, hot to the touch, red, sharply painful when touched. In severe cases, discharge of pus from the ear is observed.

  Diagnostics

  Otorhinolaryngologists, in addition to collecting anamnesis and complaints, use the following research methods:

  • Otoscopy. The upper and posterior walls of the ear canal are edematous, the tympanic membrane swells, and pus is visualized.
  • Microotoscopy.
  • Audiometry and tuning fork tests (mastoiditis may cause hearing loss).
  • Ear culture to detect bacteria and determine their susceptibility to antibiotics.
  • X-ray of the temporal bone.
  • CT or MRI of the skull.
  • Clinical blood test (increased white blood cell count, elevated ESR).

  Treatment

  For therapy:

  • Broad-spectrum antibiotics.
  • Non-steroidal anti-inflammatory drugs.
  • Immunomodulators (interferon stimulators).
  • Disinfectants.
  • Antiallergics.

  As a surgical aid, the mastoid process is drained, opened and the damaged cells are removed, and, if necessary, a complete resection of the bone.

  The most common complications are:
  – neuritis of the facial nerve;
  – thrombophlebitis and phlebitis;
  – labyrinthitis;
  – encephalitis, meningitis, brain abscesses;
  – sepsis.

  There is no specific prophylaxis. It is recommended to treat inflammation of the middle ear in a timely and complete manner, to prevent hypothermia and injuries.

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Periodontitis

The classic signs of periodontitis are the presence of a sharp localized pain of a permanent nature. Initially, in acute periodontitis, mild aching pain is noted, which is localized and corresponds to the area of ​​the affected tooth.

Later, the pain becomes more intense, tearing and throbbing, sometimes the pain radiates to the area of ​​the eye, temple, ear, which indicates a transition to purulent inflammation. There is a feeling that the diseased tooth is moving out of the dental arch (a symptom of a grown tooth), when chewing there is a sharp pain, it becomes mobile.

The general condition also worsens: malaise, headache, body temperature (due to toothache) rises to 37-38 °C.

If at least one symptom of this disease appears, you should seek the advice of a specialist. In our clinic, the doctor’s consultation will include drawing up a treatment plan for at least one tooth, at least for the entire oral cavity, and also, if necessary, an X-ray examination on a radiovisiograph is already included in the consultation. At the consultation, the doctor will explain to you all the stages of treating your tooth, as well as describe in detail the cost of each stage.

Periodontitis

Periodontitis is an inflammatory periodontal disease that occurs at the apex of the tooth root. Periodontium is called the ligaments of the tooth, which are located in a narrow gap between the bone and teeth. Periodontitis is a more serious disease than caries and pulpitis. The inflammatory process occurs as a result of infection and toxins entering the tooth ligaments through the root canal.

Stages of development of periodontitis 9There are two main groups of periodontitis: chronic and acute. As a rule, acute periodontitis is less common. Experts explain this fact by the fact that with the development of inflammation in periodontal tissues, there is an outflow of exudate and the patient may not notice at all, for several years, the presence of such a disease.

Symptoms of periodontitis

Acute periodontitis has the following symptoms: constant sharp pressing or tearing pains in the area of ​​the causative tooth, which are necessarily aggravated by touching, pressing or tapping on it. There is a feeling of a grown tooth. There is swelling of the soft tissues of the lips, gums or cheeks in the area of ​​the diseased tooth, the tooth itself has some degree of mobility. Quite often, a fistula is formed on the gum in the projection of the root apex, from which pus flows. Fistulas are most often formed with periodontitis in children, but they also occur in adults. The fistula is a channel that is designed for the outflow of purulent exudate from the inflammatory focus. The lymph nodes are also enlarged.

Chronic periodontitis may not appear for a long time and generally proceed without any symptoms. The only thing the patient remembers is that this tooth, once upon a time, hurt him. On examination, the tooth is severely destroyed and its crown is changed in color to gray, especially in the cervical region. The mucosa is pasty and edematous.

Chronic periodontitis

Exacerbation of chronic periodontitis occurs with the same symptoms as acute, the only difference will be revealed on the x-ray. Any chronic periodontitis destroys bone tissue and this will be visible on the X-ray.

Causes of periodontitis

Dentists identify several main causes of this disease: acute or chronic inflammation of the tooth pulp, untreated carious processes, dental injuries. Most often, periodontitis occurs due to infection. Infection in the periodontium can also be caused by diseases such as periostitis and osteomyelitis.

Diagnosis of periodontitis

The doctor makes a diagnosis on the basis of a survey, clinical picture and additional methods of examination of the patient. Additional methods: x-ray and EDI. In simple words, EDI is the reaction of the pulp to an electric current, do not be afraid, the procedure is absolutely painless. Periodontitis produces EDI values ​​of more than 100 microamperes. On x-ray, as a rule, a cavity near the top of the tooth is visible in the form of a dark shadow of various diameters.

Treatment of periodontitis

If you have symptoms of this disease, you should immediately consult a doctor. It is strictly forbidden to heat the area of ​​​​inflammation in any way. Warming only worsens the condition and increases the rate of development of the inflammatory process. Delaying the treatment process at best leads to chronic processes, at worst – to severe complications.

Stages of treatment of periodontitis

There are several types of periodontitis, treatment tactics depend on many factors: the duration of pain, the nature of x-ray changes, the patient’s complaints, the results of additional studies. Treat periodontitis as a rule for 2-3 visits.

The first visit is carried out:

For accuracy, the doctor makes a diagnostic x-ray

– Anesthesia

– Removal of hard tissues of the tooth affected by caries.

– Removal of dead pulp or unsealing of the canals of the tooth, if the tooth was previously treated due to pulpitis.

– Instrumental and medical treatment of all root canals.

– Canal filling with various medicinal pastes

– Temporary filling.

For a repeat visit, the patient must come after the time indicated by the doctor (from several days, then 2-3 months). The temporary filling is removed, drugs are also removed from the root canals. The canals are washed again with antiseptic preparations (chlorhexidine, sodium hypochlorite). In the absence of complaints, clinical signs of periodontitis, the canals are sealed with permanent filling materials (gutta-percha pins and special cement for root canals). An X-ray is taken to control the quality of canal filling.

In most cases, the tooth can be immediately restored with a filling after canal filling, if, due to the amount of resolution, the tooth cannot be restored even with the use of fiberglass and anchor pins, then an orthopedic restoration (metal-ceramic or zirconium crown) is necessary. When referring to an orthopedist, an additional consultation is not paid, the orthopedist will restore your tooth in 2-3 visits.

The picture below shows all stages of treatment well:

Prevention and complications

Prevention of periodontitis includes timely treatment of caries, pulpitis and gum disease by a dentist.